In the automotive industry, a number of headrests or head restraints are available on vehicle seats that include systems for adjusting a position of the headrest to accommodate a variety of vehicle occupants and their specific support needs. Adjustment systems, particularly powered systems, can take up a considerable amount of space which is at a premium at the headrest. Thus, a headrest assembly that can provide adequate adjustment is desired in order to satisfy the needs of various vehicle occupants, and further, providing a climate control feature within the constraints to of the headrest assembly is also desired.